The complex tumour microenvironment is a crucial regulator of anti-tumor immune responses in gynecologic cancers. How cancer cells interact with the diverse population of immune effector cells has a substantial impact on the efficacy of traditional chemotherapy and cutting-edge immunotherapy methods. In this study, we focus specifically on the role of macrophages in ovarian, endometrial, and cervical cancers. We discuss the evolution of macrophages and how their polarisation status is influenced by the stimuli in their surroundings. By fostering tumour growth and controlling immune-suppression, tumor-associated macrophages (TAMs) in the tumour microenvironment affect treatment outcomes. We outline clinical strategies that particularly target TAMs, such as limiting macrophage differentiation, blocking immunological checkpoints, reducing monocyte recruitment to the tumour, and preventing immune checkpoint blockade.
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